百草枯对人胚胎神经干细胞分化过程中Wnt通路分子表达的影响

[目的]通过对神经干细胞Wnt信号通路中关键分子β-catenin/D VL2基因表达的研究,探讨百草枯对分化中的神经干细胞Wnt/β-catenin信号通路的影响. [方法]以人胚胎神经干细胞为研究对象,观察体外诱导分化情况,并采用四甲基偶氮唑盐(MTT)法测定不同浓度百草枯对细胞活力的影响,选取未观察到细胞毒性的浓度为0.10、1.00、10.00 μmol/L的百草枯染毒,在分化2、4、8、12d利用实时荧光定量多链聚合反应技术检测Wnt信号通路关键分子β-catenin和DVL2 mRNA的表达情况. [结果]百草枯在100.00 μmol/L时可明显抑制细胞活力(P＜0.01).百草枯在神经干细胞分化期2、8、12d明显下调β-catenin mRNA的表达,除10.00μmol/L染毒组在分化期8d以外,其余各剂量组与对照组相比,差异具有统计学意义(P＜0.01).百草枯在神经干细胞分化期2、12d DVL2 mRNA的表达明显下调,除0.10μmol/L染毒组在分化期12d该基因mRNA表达升高外,其余各剂量组与对照组相比差异均有统计学意义(P＜0.01);在分化期4dDVL2 mRNA的表达明显上升,各剂量组与对照组相比差异具有统计学意义(P＜0.01). [结论]百草枯抑制Wnt信号通路中关键分子β-catenin和DVL2基因mRNA的表达,最终可影响神经干细胞的分化过程.     

TGF-β1-Smad2/3信号转导通路在百草枯中毒致肺纤维化中的作用

目的观察百草枯(PQ)染毒对人肺成纤维细胞的影响,探讨PQ中毒致肺纤维化中转化生长因子β1-Smad2/3蛋白(TGF-β1)-Smad2/3信号转导通路的作用。方法体外培养人胚肺成纤维细胞(MRC-5),以终浓度为0、12.5、25、50、100、200、400μmol/L的PQ处理细胞24h,四甲基偶氮唑蓝(MTT)检测细胞存活率。使用终浓度50μmol/L PQ处理细胞6、8、12、24、48、72h,检测PQ在不同时间点对细胞的损伤程度。终浓度0、25、50、100μmol/L PQ处理细胞24h,酶联免疫吸附(ELISA)检测细胞TGF-β1蛋白表达水平,聚合酶链反应(RT-PCR)检测细胞TGF-β1 mRNA表达水平。为了观察PQ染毒对TGF-β1/Smad信号通路的影响,将MRC5细胞分成6组:正常对照组、25μmol/L PQ染毒组、50μmol/L PQ染毒组、100μmol/L PQ染毒组、TGF-β1阳性对照组、TGF-β1刺激组(100μmol/L PQ+50μmol/L TGF-β1),免疫印迹法(Western blot)检测磷酸化Smad2/3蛋白(p-Smad2/3)表达水平。结果与对照组比较,MRC-5细胞存活率随着PQ剂量和时间的增加明显降低(P0.05),呈剂量和时间依赖性;ELISA显示,PQ作用MRC-5细胞24h后,TGF-β1蛋白表达升高至37.4、48.8、39.3μg/ml,但诱导作用呈非剂量依赖方式;RT-PCR显示,随着PQ浓度增加TGF-β1mRNA表达水平明显升高,分别是对照组的3.5、6.9和9.7倍,诱导作用呈剂量依赖方式(P0.05);Westem blot显示,浓度为25、50、100μmol/L PQ作用细胞24h后,p-Smad2、p-Smad3蛋白表达水平明显升高(P0.05),给予细胞100μmol/L PQ+50μmol/L TGF-β1共同刺激下,p-Smad2、p-Smad3蛋白量达到最多(P0.05)。结论TGF-β1、pSmad2、p-Smad3的异常表达参与了PQ致MRC5细胞损伤过程,TGF-β1/Smad信号通路激活在PQ致肺纤维化中发挥重要作用。     

三甲基氯化锡诱导PC12细胞凋亡的机制

目的 在体外条件下,研究三甲基氯化锡(trimethyltin chloride,TMT)对PC12细胞增殖、细胞凋亡及细胞氧化损伤的作用,并探讨TMT对NF-kB表达的影响.方法 (1)不同浓度TMT(0、0.3125、0.6250、1.2500、2.500、5.000、10.000、20.000 μmol/L)处理PC12细胞24、48 h,噻唑蓝(MTT)法测定细胞存活率;(2)1.25、2.50、5.00、10.00 μmol/L TMT分别染毒PC12细胞12、24h后,流式细胞仪检测检测细胞凋亡率;(3)1.25、2.50、5.00、10.00 μmol/L剂量的TMT染毒PC12细胞6h后,测定活性氯(ROS)和谷胱甘肽(GSH)含量的变化;(4)1.25、2.50、5.00、10.00 μmol/L剂量的TMT染毒PC12细胞12h后免疫印迹法(Western blot)检测核蛋白NF-kB的水平.结果 与溶剂对照组比较,染毒24 h,2.5000、5.0000、10.0000、20.0000 μmol/L TMT剂量组细胞存活率明显下降;染毒48 h,1.2500、2.5000、5.0000、10.0000、20.0000 μmol/L剂量组细胞存活率明显下降,差异均有统计学意义(P＜0.05).1.25、2.50、5.00、10.00 μmol/L TMT染毒细胞12h,凋亡率分别为15.30％±0.75％、18.90％±0.61％、22.00％±0.60％、36.50％±0.66％,染毒24 h凋亡率分别为28.60％±0.40％、43.54％±2.00％、65.73％±0.71％、74.67％±0.40％,明显高于对照组[12 h:(12.80％±1.00％)、24 h:(16.83％±0.25％)],差异均有统计学意义(P＜0.05).1.25、2.50、5.00、10.00 μmol/L剂量组的ROS荧光强度值分别为对照组的1.42、1.71、1.78、1.89倍,差异有统计学意义(P＜0.05).2.50、5.00、10.00 μmol/L组GSH含量分别为(0.17±0.0)、(0.20±0.04)、(0.07±0.03)μmol/μg pro,明显低于对照组(0.30±0.01) μmol/L pro,差异有统计学意义(P＜0.05).2.50、5.00、10.00 μmol/L剂量组NF-kB p65表达的蛋白条带灰度值明显高于对照组,差异有统计学意义(P＜0.05).结论 在本实验条件下,TMT对PC12细胞具有明显抑制增殖和诱导凋亡的作用,其作用可能与氧化应激以及NF-kB信号通路的激活有关.     

PDTC对百草枯致肺纤维化大鼠结缔组织生长因子及Ⅰ、Ⅲ型胶原的影响

目的 观察急性百草枯(PQ)中毒大鼠肺组织结缔组织生长因子(CTGF)、Ⅰ型胶原(ColⅠ)、Ⅲ型胶原(ColⅢ)的动态变化及四氢吡咯二硫代氨基甲酸酯(PDTC)的干预效果,探讨PQ致肺纤维化机制及PDTC干预作用.方法 SD大鼠随机分为对照组(6只)、PQ染毒组(56只)、PDTC干预组(46只).染毒组和干预组给予PQ(80 mg/kg)一次性灌胃后2h,染毒组给予等量生理盐水腹腔注射,PDTC干预组给予PDTC(100mg/kg)一次性腹腔注射;对照组给予生理盐水1 ml/kg灌胃后2h,给予等量生理盐水腹腔注射.于不同处理后1、3、7、14、25、56 d蛋白免疫印迹法(Western blot)测定大鼠肺组织CTGF蛋白表达;实时荧光定量多聚酶链式反应(real-time PCR)测定CTGF、Col Ⅰ、ColⅢmRNA表达水平;同时测定肺组织羟脯氨酸(hyp)含量,观察中毒大鼠的肺组织病理变化.结果 染毒组大鼠肺组织CTGF蛋白表达随时间延长而逐渐升高,3～14d升高幅度缓慢,28～56d增幅较大,各时点均明显高于对照组,差异有统计学意义(P＜0.05或P＜0.01).染毒组大鼠肺组织CTGF mRNA表达水平于染毒后1d即明显升高,3～14d表达迅速升高,28～56 d维持在较高水平,各时点均明显高于对照组,差异有统计学意义(P＜0.01).染毒组染毒后1、3 d Col Ⅰ mRNA表达无明显变化,7d表达略微增强,14～56 d水平大幅度升高,与对照组比较,7～56 d mRNA水平明显升高,差异有统计学意义(P＜0.05或P＜0.01);染毒组ColⅢmRNA水平于染毒后1d即开始升高,7d达到高峰,之后呈下降趋势,各时点均明显高于对照组,差异有统计学意义(P＜0.05或P＜0.01);Masson染色可见染毒后14～28 d成纤维细胞大量增殖,胶原纤维数量逐渐增多.与染毒组比较,PDTC干预组大鼠肺组织CTGF蛋白表达降低、CTGF、Col Ⅰ、ColⅢmRNA表达下调,相应时点的差异有统计学意义(P＜0.05或P＜0.01).结论 CTGF表达持续增高;可能通过上调Col Ⅰ、ColⅢ转录水平,增加胶原分泌和基质合成,在PQ所致肺纤维化中起重要作用;PDTC抑制了上述因子的表达,可以减轻PQ中毒大鼠的肺损伤.     

百草枯中毒大鼠肺组织血栓调节蛋白和内皮细胞蛋白C受体表达的变化及二巯丙磺钠的作用

目的 观察急性百草枯(paraquat,PQ)中毒大鼠肺组织中血栓调节蛋白(thmmbomodulin,TM)及内皮细胞蛋白C受体(endothelial protein C receptor,EPCR)mRNA表达的变化及二巯丙磺钠(Na-DMPS)的十预作用.方法 80只雄性SD大鼠随机分为4组:正常对照组(8只);Na-DMPS对照组(8只,腹腔注射200 mg/kgNa-DMPS);PQ染毒组,32只,腹腔注射体积分数为1%的PQ溶液(20mg/kg)];Na-DMPS保护组[32只,腹腔注射200 mg/kg Na-DMPS 15 min后再腹腔注射体积分数为1%的PQ溶液(20 mg/kg)].检测PQ染毒组及Na-DMPS保护组染毒后6 h及1、3、7 d肺组织中TM mRNA、EPCRmRNA的表达,并观察大鼠肺组织的病理学变化.结果 PQ染毒组染毒后3 d内炎性细胞(如中性粒细胞、淋巴细胞等)浸润明显,伴充血水肿;Na-DMPS保护组炎性细胞浸润较PQ染毒组少,充血水肿轻.与对照组相比,PQ染毒组及Na-DMPS保护组大鼠肺组织中TM mRNA、EPCR mRNA的表达增强,在6 h达高峰,1 d开始下降,7 d降至正常水平.Na-DMPS保护组6 h及1 d TM mRNA表达分别为1.071±0.097、1.055±0.051,与PQ染毒组比较,明显降低,差异有统计学意义(P<0.05或P<0.01);Na-DMPS保护组6 h及1 d EPCR mRNA表达分别为0.678±0.005、0.650±0.007,与PQ染毒组比较,明显降低,差异有统计学意义(P<0.05或P<0.01).结论 大鼠急性PQ中毒后肺组织中TM mRNA、EPCRmRNA的表达升高,预防性应用Na-DMPS后,TM mRNA、EPCR mRNA的表达降低.     

槲皮素对百草枯染毒肺上皮细胞存活率和上皮间质转化标志的影响

  目的  探讨槲皮素（Que）对百草枯（PQ）处理肺上皮细胞（MLE-12）的存活率和上皮间质转化（epithelial-mesenchymal transition，EMT）的影响及机制。
  方法  采用CCK-8法分别检测不同剂量PQ（50、150、450 μmol/L）对MLE-12细胞存活率的影响。实验设立空白对照组、阳性对照组、PQ（150 μmol/L）+Que（30、60、90μmol/L）干预组、阴性对照组，在Que干预24 h后检测细胞存活率。应用荧光定量PCR法和蛋白免疫印迹（Western blot）法分别检测α-SMA、结缔组织生长因子（connective tissue growth factor，CTGF）、E-Cadherin、TGF-β1、Smad3、Akt、mTOR的mRNA和蛋白表达。
  结果  经PQ（150 μmol/L）处理后，60 μmol/L和90 μmol/L的Que能够显著提高MLE-12细胞存活率，与阳性对照组比较差异有统计学意义（P < 0.05）。荧光定量PCR法和Western blot法检测结果表明，与空白对照组比较，50 μmol/L的PQ能提高α-SMA、CTGF、E-Cadherin、TGF-β1、Smad3、Akt、mTOR的mRNA表达，以及α-SMA、CTGF、E-Cadherin、TGF-β1、Smad3、Akt的蛋白表达（P < 0.05）；150 μmol/L的PQ能提高TGF-β1和mTOR的mRNA表达，以及α-SMA、E-Cadherin、TGF-β1、Smad3的蛋白表达（P < 0.05）；450 μmol/L的PQ能提高CTGF和Smad3的mRNA表达，以及α-SMA、E-Cadherin、Smad3的蛋白表达（P < 0.05）。在不同浓度Que干预PQ（150 μmol/L）染毒的MLE-12细胞后，与阳性对照组相比，30 μmol/L的Que能降低α-SMA、TGF-β1、Akt、mTOR的mRNA和蛋白表达水平，以及α-SMA、CTGF、Akt、mTOR的蛋白表达水平（P < 0.05）；60 μmol/L的Que能提高CTGF、E-Cadherin、Smad3、Akt的mRNA表达水平，以及α-SMA、Smad3、mTOR的蛋白表达水平（P < 0.05）；90 μmol/L的Que能降低TGF-β1、mTOR的mRNA表达水平，提高CTGF的mRNA表达水平，降低Akt、mTOR的蛋白表达水平（P < 0.05）。
  结论  百草枯染毒可能通过TGF-β1诱导细胞发生上皮间质转化。槲皮素干预能提高百草枯染毒MLE-12细胞的存活率，并能改变细胞上皮间质转化程度，其机制可能是通过调控TGF-β1/Smad和Akt/mTOR信号通路实现。
     

AMPK-mTOK信号通路参与百草枯致PC12细胞的自噬抑制作用

目的探讨AMPK-mTOR信号转导通路在百草枯(paraquat,PQ)诱导大鼠肾上腺髓质嗜铬细胞瘤细胞(PC12)自噬异常中的调控作用。方法用终浓度0、25、50、100、200、300、400 μmol/L PQ处理PC12细胞24 h,300 μmol/L PQ处理细胞不同时间(6、12、24、48 h),四甲基偶氮唑蓝(MTT)检测细胞相对存活率,确定剂量/时间-效应关系;终浓度0、100、200、300 μmol/L PQ处理细胞24 h,分光光度法检测培养上清中乳酸脱氢酶(LDH)活力;二氯荧光素双醋酸盐(DCFH-DA)法检测细胞内活性氧(ROS)水平;单丹磺酰尸胺(MDC)染色法观察自噬溶酶体的表达及分布变化;免疫荧光(IF)检测微管相关蛋白1轻链3(LC3)表达水平;免疫印迹法(Western blot)检测自噬相关蛋白LC3Ⅱ、p62、Beclin1及AMPK-mTOR信号通路蛋白p-AMPK、p-mTOR表达水平。结果与对照组比较,100、200、300、400 μmol/L PQ染毒组的细胞存活率明显降低,且呈剂量依赖关系,差异有统计学意义(P<0.05)。300 μmol/L PQ处理细胞不同时间(6、12、24、48 h),细胞存活率随染毒时间的延长而下降,其中12、24、48 h染毒组的差异有统计学意义(P<0.05)。与对照组比较,100、200、300 μmol/L PQ染毒组细胞上清液中LDH活力明显升高,细胞内ROS荧光强度明显增高,差异有统计学意义(P<0.05);MDC染色结果显示,PQ染毒组的自噬溶酶体在核周分布密度降低、荧光强度减弱、自噬水平降低;免疫荧光结果显示,PQ染毒组的LC3荧光强度减弱,细胞自噬水平下降,与MDC染色结果一致。Western blot结果显示,与对照组比较,PQ染毒组的自噬相关蛋白LC3Ⅱ、Beclin1表达水平均明显降低,而p62蛋白表达水平升高,差异有统计学意义(P<0.05)。200、300 μmol/L PQ染毒组的p-AMPK蛋白表达水平降低,p-mTOR蛋白表达水平升高,差异有统计学意义(P<0.05)。结论PQ致PC12细胞损伤过程中,细胞自噬水平降低,AMPK-mTOR信号通路发挥调节作用。     

锰致PC12细胞PARK2表达对多巴胺分泌的修饰作用

[目的]研究锰在不同剂量和不同时间下对鼠嗜铬神经瘤细胞(PC12)中多巴胺含量和PARK2表达的影响.[方法]鼠PC12细胞分别以(1)0、100、300、500 μmol/L浓度的氯化锰(MnCl2)染毒24h; (2)500 μmol/L MnCl2染毒6、24、48h.采用反相高效液相-荧光法测定细胞内多巴胺含量,实时荧光定量聚合酶链反应检测PARK2 mRNA水平. [结果]随着染毒浓度的增高,多巴胺含量及PARK2 mRNA表达呈下降趋势.与对照组比较,300 μmol/L或以上浓度MnCl2染毒所致多巴胺含量降低和PARK2 mRNA表达降低(P＜0.01).500 μmol/L MnCl2分别染毒6、24、48h,多巴胺含量明显降低(P＜0.01),PARK2 mRNA表达下调(P＜0.05). [结论]锰可致PC12细胞多巴胺含量减少,可能与PARK2的表达下调有关.     

Notch信号通路在妊娠期DN小鼠中的表达意义

目的探究Notch信号通路在妊娠期糖尿病肾病(DN)小鼠肾组织中的表达意义。方法采用链脲佐菌素(STZ)建立DN小鼠模型,DN小鼠(腹腔注射STZ溶液)和对照组小鼠(腹腔注射等量枸椽酸盐缓冲液),每组各6只,2、4、8周时分别收集小鼠血液检测生化指标,8周末处死小鼠取其肾脏组织,HE染色观察两组小鼠肾组织形态,免疫组织化学染色观察两组小鼠肾组织Notch1表达情况,Western blot检测Notch信号通路中Notch1、Jagged1、Hes1、Hey1蛋白表达水平,Real-time PCR检测Notch信号通路中的Notch1、Jagged1、Hes1和Hey1 mRNA相对表达量。结果2周、4周、8周时,DN组小鼠血糖(Glu)、糖化血红蛋白(HbA1c)、血肌酐(Scr)、尿素氮(BUN)及尿酸(UA)水平均显著高于对照组小鼠,且HbA1c、Scr、BUN及UA水平随着DN病程延长而升高(DN组2周vs.对照组:t值分别为11.804、7.481、2.362、5.621、2.557;DN组4周vs.对照组:t值分别为14.431、9.936、4.449、7.329、3.977;DN组8周vs.对照组:t值分别为12.415、13.593、7.619、9.654、6.981,P<0.05)。DN组小鼠Notch1、Jagged1、Hes1和Hey1蛋白表达水平均显著高于对照组小鼠(t值分别为3.781、9.738、12.231、6.684,P<0.05)。DN组小鼠Notch1、Jagged1、Hes1和Hey1 mRNA相对表达量均显著高于对照组小鼠(t值分别为6.411、9.510、15.490、9.498,P<0.05)。结论DN小鼠肾组织中Notch信号通路蛋白表达明显增加,Notch信号通路可能在DN肾脏损害的发生和发展中发挥着重要作用。     

急性百草枯中毒大鼠肺组织炎症因子表达的变化及意义

目的 观察急性百草枯(PQ)中毒大鼠肺组织中炎症因子表达的变化,探讨早期及晚期炎症因子在急性PQ中毒肺损伤中的作用.方法 50只雄性SD大鼠随机分为2组:正常对照组(10只,生理盐水腹腔注射),PQ染毒组(40只,腹腔注射体积分数为1%的PQ溶液,20 mg/kg).PQ组于染毒后6 h及1、3、7 d处死,正常对照组于处理后1 d处死,检测肺组织中肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、高迁移率族蛋白-1(HMGB-1)mRNA的表达,并观察大鼠的中毒表现及肺组织的病理改变.结果 PQ染毒组大鼠肺组织病理表现为早期充血水肿明显,大量炎性细胞浸润.与正常对照组相比,PQ染毒组大鼠肺组织中TNF-α、IL-10、HMGB-1 mRNA的表达在各时间点均有不同程度升高.PQ染毒组6 h和1 d时TNF-α mRNA表达分别为0.740±0.100和0.584±0.049,1、3 d时IL-10mRNA表达分别为0.551±0.016和0.524±0.010,6 h及1、3 d时HMGB-1 mRNA表达分别为0.695±0.060、0.87±0.154和0.819±0.188,与对照组比较,均明显升高,差异均有统计学意义(P<0.05或P<0.01).结论 大鼠急性PQ中毒后肺组织中TNF-α、IL-10及HMGB-1 mRNA的表达明显上调,早期及晚期炎症因子均参与PQ急性中毒肺损伤的致病过程.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.